Individual provider Active NPI

Courtney C Wilkinson, APRN

  • Gerontology Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1528685807
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
123430 Issued in AR
Practice address
9601 Baptist Health Dr
Little Rock, AR 72205-6321
Phone
(501) 202-2000
NPI assigned
Jul 2, 2020
Last updated
Jul 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 123430 AR Primary

Addresses

Primary practice location

9601 Baptist Health Dr
Little Rock, AR 72205-6321

Mailing address

6808 Evergreen Dr
Little Rock, AR 72207-6324
Phone (501) 773-4650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200826000478 AR Practitioner - Nurse Practitioner 8820415698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

9601 Baptist Health Dr
Little Rock, AR 72205-6321
Phone (501) 812-7215

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
123430ARMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group CurrentSince Jul 13, 2020 Accepting new patients
Arkansas Health Group CurrentSince Jul 13, 2020 Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

9601 Baptist Health Dr
Ste 1B
Little Rock, AR 72205
Phone (501) 812-7215

9601 Interstate 630
Little Rock, AR 72205
Phone (501) 202-2300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1528685807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6808 EVERGREEN DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722076324",
            "telephone_number": "501-773-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BAPTIST HEALTH DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056321",
            "telephone_number": "501-202-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "COURTNEY",
        "middle_name": "C",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AR",
            "license": "123430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.